Abbot Laptook Professor of Pediatrics

Brown Affiliations

research overview

My research focus has been the effects of insufficient oxygen (hypoxia) and blood flow (ischemia) on the brain of infants born at term or near term. If severe enough, hypoxia-ischemia can lead to serious brain injury and ultimately delayed development and cerebral palsy. Hypoxia-ischemia represents a condition in which brain development has been normal until the time of hypoxia-ischemia. Effective treatments could minimize the extent of injury; my research has centered on brain cooling as a potential therapy for this condition.

research statement

The focus of my research efforts has been to function as the Principal Investigator for the Brown site of the NICHD Neonatal Research network (located at WIHRI). The network is a consortium of 18 large academic neonatal centers from across the US that pools their patients to test important concepts which typically can not be performed in a single center. My role has been to contribute and conduct clinical studies of the Network in our NICU and Follow-Up clinic. My primary area of research within the multiple studies conducted by the Network has been hypoxic-ischemic brain injury in the term infant. This interest stems from more than 20 years of animal working investigating brain ischemia since this injury remains an important cause of neurodevelopmental deficits during childhood and cognitive impairment at school age. The present goals are to examine variables that modify the impact of hypoxia-ischemia on the brain and provide rationale and justification to undertake clinical trials of potential neuroprotective strategies. I previously served as the Co-Investigator for a multicenter, randomized trial of body cooling for term infants manifesting encephalopathy within the first 6 hours of life. I currently serve as the Principal Investigator on a second study of therapeutic hypothermia which is designed to determine if body cooling to 33.5°C is effective if started between 6 and 24 hours of age.

Separate from the Network studies, I have strong interests in thermal regulation, use of the amplitude integrated EEG (aEEG) to increase our understanding of the pathogenesis of brain injury, moderate and late preterm infants, and non-invasive methods to measure brain temperature. Former fellows have been involved in the following studies: associations between placental expression of cytokines and development of BPD, a small randomized pilot clinical trial of nasal ventilation, a cross-sectional study among infants with and without BPD to determine abnormalities on aEEG, a prospective evaluation of the extent of agreement between measured end tidal CO2 and arterial pCO2, a cohort study using the aEEG as a predictor of morbidities/length of stay for infants born at 34 weeks gestation, the association between early pulmonary hypertension and the development of BPD and the temporal sequence of changes in pulmonary artery pressure during the neonatal course for extremely preterm infants. Current work involves the use of aEEG combined with other measures of autonomic function (respiratory and heart rate variability) in moderate and late preterm infants as a predictor of length of hospital stay. (updated 5.16.13)

funded research

Principal Investigator, National Institutes of Health, "Multicenter Network of Neonatal Intensive Care Units", April 2011 – March 2016, No.5-U10-HD027904-21

Co-Sponsor, Principal Investigator, Lina Chalak, MD, National Institutes of Health, "Cerebrovascular Dysfunction in Newborns with HIE During Hypothermia and Rewarming", July 2012, 1K23HD069521-01A1

Mentor, Principal Investigator, Lina Chalak, MD, North and Central Texas Clinical and Translational Science Initiative Pilot Grant Award Program, "Optimizing Hypothermia Therapy: A Pilot Study for Evaluation of the Rewarming Phase in Newborn with Hypoxic-Ischemic Encephalopathy", June 2010- May 2011

Site Principal Investigator, National Institutes of Health, "Prophylactic Phenobarbital After Resolution of Neonatal Seizures", September 2009 – November 2011, R01-HD057977 (Closed due to lack of recruitment)

Principal Investigator, National Institutes of Health, "Multicenter Network of Neonatal Intensive Care Units", April 2006 – March 2011, No.5-U10-HD027904-16

Co-Principal Investigator, NICHD "Multicenter Network of Neonatal Intensive Care Units", April 2001 – March 2006, No. 5-U10-HD027904-13 (Co PI Role 2004-2006)

Co-Investigator, ThermoTek, Inc., "Comparison of ThermoTek and Cincinnati Sub-Zero Cooling Systems," October 2005 – December 2005

Principal Investigator, National Institutes of Health, "Multicenter Network of Neonatal Intensive Care Units", April 2001 - March 2006, No. 1-U10-HD40689-03 (PI Role 2001-2003)

Co-Investigator, National Science Foundation, No. CTS50222504, Principal Investigator – Yildiz Bayazitoglu, PhD, "Thermal Modeling of the Head and Neck, October 2002-January 2004

Consultant, Principal Investigator – Myra Wyckoff, M.D., Neonatal Resuscitation Program, "Randomized Controlled Trial of Albumin or Normal Saline on Resuscitation in an Asphyxiated Hypotensive Neonatal Model", January 2002- January 2003

Co-Investigator, National Institutes of Health, No. 5-U10-HD21373, "Multicenter Network of Neonatal Intensive Care Units," April, 1999 - March, 2001

Principal Investigator, United Cerebral Palsy, No. R-411-93, "Neonatal Neuroprotection Provided by Modest Hypothermia", October 1, 1993 - September 30, 1995

Principal Investigator, United Cerebral Palsy, No. R-411-91, "Is Modest Hypothermia Beneficial for Ischemic Neonatal Brain", October 1, 1991 - September 30, 1993

Co-Investigator, National Institutes of Health, No. 1R01-HD-20720, Fetal Hormonal Adaptation to Intrauterine Stress", July 1986 - June 1989

Principal Investigator, National Institutes of Health, No. 1-R23-NS-22398, "Cerebrovascular and Metabolic Effects of Brain Ischemia", September 1985 - August 1988

Principal Investigator, American Heart Association, No. 83714, "Cerebral Hemodynamics of Sodium Bicarbonate in Newborn Swine", July 1983 - June 1985

Principal Investigator, University of Texas Southwestern Medical Center, 2 S07 RR05426-20 Biomedical Research Support Grant, "Newborn Piglet Brain Blood Flow: An Evaluation of Regional Differences", July 1981-June 1982